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A Minimally Invasive Technique for the Detection and Analysis of Pulmonary Fat Embolism: A Feasibility Study

Authors

  • Laura Filograna M.D.,

    1. Department of Legal Medicine, Centre of Forensic Imaging and Virtopsy, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
    2. Department of Legal Medicine, Institute of Forensic Medicine, Catholic University of Rome, Largo F. Vito 1, 00168 Rome, Italy.
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  • Stephan A. Bolliger M.D.,

    1. Department of Legal Medicine, Institute of Forensic Medicine, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
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  • Beat Kneubuehl Ph.D.,

    1. Department of Legal Medicine, Centre of Forensic Imaging and Virtopsy, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
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  • Christian Jackowski M.D.,

    1. Department of Legal Medicine, Centre of Forensic Imaging and Virtopsy, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
    2. Department of Legal Medicine, Institute of Forensic Medicine, Post Mortem Imaging Center, University of Zurich, Winterthurerstrasse 190, CH-8057 Zürich, Switzerland.
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  • Gary M. Hatch M.D.,

    1. Department of Legal Medicine, Centre of Forensic Imaging and Virtopsy, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
    2. Department of Legal Medicine, Institute of Forensic Medicine, Post Mortem Imaging Center, University of Zurich, Winterthurerstrasse 190, CH-8057 Zürich, Switzerland.
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  • Michael J. Thali M.D.

    1. Department of Legal Medicine, Centre of Forensic Imaging and Virtopsy, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
    2. Department of Legal Medicine, Institute of Forensic Medicine, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland.
    3. Department of Legal Medicine, Institute of Forensic Medicine, Post Mortem Imaging Center, University of Zurich, Winterthurerstrasse 190, CH-8057 Zürich, Switzerland.
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  • Presented at the 88th Annual Meeting of the German Society of Legal Medicine (DGRM), September 22–26, 2009, in Basel, Switzerland, and at the 62nd Annual Meeting of the American Academy of Forensic Sciences, February 22–27, 2010, in Seattle, WA.

Additional information and reprint requests:
Laura Filograna, M.D.
Department of Bioimaging and Radiological Sciences
Catholic University of Rome
Largo F. Vito 1
00168 Rome
Italy
E-mail: laura.filograna@rm.unicatt.it

Abstract

Abstract:  We investigated the feasibility of postmortem percutaneous needle biopsy (PNB) for obtaining pulmonary samples adequate for the study of pulmonary fat embolism (PFE). Samples of both lungs were obtained from 26 cadavers via two different methods: (i) PNB and (ii) the double-edged knife technique, the gold standard at our institute. After water storage and Sudan III staining, six forensic pathologists independently examined all samples for the presence and severity of PFE. The results were compared and analyzed in each case regarding the vitality of the PFE and its relationship to the cause of death. The results showed that PFE was almost identically diagnosed and graded on the samples obtained via both methods. The discrepancies between the two techniques did not affect the diagnoses of vitality or cause of death related to PFE. This study demonstrates the feasibility of the PNB sampling method for the diagnosis and interpretation of PFE in the postmortem setting.

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